Two more illnesses have been reported in Uganda's Ebola Sudan outbreak, raising the outbreak total to nine, according to a weekly infectious disease update from the Africa Centres for Disease Control and Prevention (Africa CDC). The agency based its numbers on information from Uganda's health ministry. 

So far, the death total remains at one, putting the case-fatality rate at 11.1% Uganda is battling its first Ebola Sudan outbreak since 2022, with clusters reported in the family of the index patient—a male nurse who died in the middle of January—and another connected to a healthcare facility. 

The first patient's symptoms began on January 19, and he died 10 days later. The man had visited a traditional healer and three separate health clinics before he died in Kampala, all factors that pose a risk of further spread.

China has reported two more H9N2 avian flu infections in humans, both of them patients from Hunan province in the southern part of the country, according to a weekly avian flu update today from the Hong Kong Centre for Health Protection (CHP).

One of the patients is a 2-year-old boy whose symptoms began on December 27, which would raise the total for 2024 to 18.

The second patient is a 15-year-old boy whose symptoms began on January 8, which would mark the first H9N2 case of the new year.

The CHP report didn't say how the patients were exposed to the virus, though H9N2 infections are sporadically reported in people who have contact with poultry. H9N2 is known to circulate in poultry across parts of Asia, including China. 

Illnesses in people are often mild and reported in children.

Today the Coalition for Epidemic Preparedness Innovations (CEPI) announced an award of $5 million funding award to Ethris, a German biotechnology firm working on next-generation RNA vaccines. 

The award will help Ethris develop spray-dried RNA vaccines that remain stable at room temperature and are suitable for nasal delivery, CEPI said in a press release.

The vaccines would use spray-drying technology—the same as used in asthma inhalers—that rapidly dries liquid with hot gas to form stable powders for respiratory delivery via the nose. CEPI said the nasal administration could help to achieve mucosal immunity, a key for reducing virus transmission.

Spray-drying for RNA-based vaccines could make them more practical and accessible similar to the established standards in respiratory medicine.

"Spray-drying for RNA-based vaccines could make them more practical and accessible similar to the established standards in respiratory medicine," said Christian Plank, PhD, chief technology officer at Ethris. "With CEPI's support, we aim to demonstrate the feasibility of spray-drying for RNA formulations, enabling vaccines to remain stable at room temperature while allowing for simpler, needle-free administration. If successful, this approach has the potential to transform vaccine delivery and accessibility on a global scale."

No need for cold storage 

Importantly, spray-dry vaccines would eliminate the need for cold-chain storage, a logistical problem in many low-resource countries. Both mRNA vaccines used for COVID-19 require cold storage across the supply chain. 

"If successful, this method would enhance access to RNA-based vaccines by increasing their thermostability and offering an alternative for individuals with needle phobia," said Raafat Fahim, PhD, the interim executive director of manufacturing and supply chain at CEPI. 

People with weakened immune systems—most of whom were vaccinated—made up 4% of a random sample of more than 12 million people in England in 2023 yet represented 22% of both COVID-19 hospital admissions and deaths, according to new findings from the INvestigation oF cOvid-19 Risk among iMmunocompromised populations (INFORM) study. 

European researchers and representatives from the pharmaceutical company AstraZeneca conducted a retrospective study using the electronic health records of participants aged 12 years and older from a random 25% sample of the English population from January to December 2023.

The results were published in the Journal of Infection.

Twice the risk of hospitalization

Over the study period, 11,200 COVID-19 hospitalizations and 2,330 deaths occurred in the study sample. Immunocompromised participants accounted for 4.0% of 12.1 million people included in the sample but made up 21.7% and 21.9% of COVID-19 hospitalizations and deaths, respectively. 

Beyond three years since the start of the COVID-19 pandemic, immunocompromised individuals remain disproportionately impacted from COVID-19 despite increased vaccination.

The risk of severe COVID-19 was higher among immunocompromised than otherwise healthy people (adjusted incidence rate ratio [aIRR] for hospitalization, 2.04; aIRR for death, 1.69). 

Immunocompromised participants were more likely to have received at least four doses of COVID-19 vaccine than their non-immunocompromised peers (72.6% vs. 29.8%). The aIRRs for COVID-related consultations with a general practitioner and accident and emergency visits were 2.26 and 3.02 for immunocompromised and non-immunocompromised people, respectively.

Of the immunocompromised subgroups, the risk of COVID-19 hospital admission was highest for recipients of a stem cell transplant in the 2 years before infection (aIRR, 19.18), followed by those who had a solid organ transplant in the 5 years before infection (aIRR, 6.53). Other groups with a threefold or higher risk than those without the immune-weakening condition included those with primary immunodeficiency, end-stage kidney disease or dialysis, or blood cancers. 

"Beyond three years since the start of the COVID-19 pandemic, immunocompromised individuals remain disproportionately impacted from COVID-19 despite increased vaccination," the authors wrote. "These findings highlight a persistent need for additional COVID-19 interventions for immunocompromised populations."